1. Field of the Invention
The present invention relates to an endo-bag to take in a removed organ as in an endoscopic surgery or an operation under an endoscopic examination and means for inserting the endo-bag into the abdominal cavity.
2. Description of the Prior Art
The endoscopic surgery is performed in the operation of the abdominal cavity and pectoral cavity. In this style of operation, the whole of the abdomen is not cut open. Instead, a minimum necessary part is cut open or holed, and through that opening are inserted a laparoscope and surgical instruments such as forceps and electric surgical knife with which a diseased organ is removed in the abdominal cavity under an endoscopic examination. This surgery is widely conducted lately, because a small abdominal opening does do for operations and helps quicken post-operation recovery and minimizes the creeping in of virus.
To prevent the operation from affecting the other parts, an endo-bag is used to take in a removed organ in the abdominal cavity. Then, the removed organ is cut in small pieces within the bag or put out of the cavity as it is removed. Since the diseased organ is taken in the bag immediately after surgery and all the subsequent treatment of the diseased organ is done within the bag, there is no possibility of the other parts of the body being affected even if the disease is a malignant tumor. This way, the endo-bag minimizes the adverse effect of operation on the patient.
In the meantime, the endoscopic operation is limited in degree of freedom of operation as compared with laparotomy because of the small trocar site, the limited visibility, ocellar observation of the laparoscope, and other factors. And the problem in using an endo-bag in the abdominal cavity is how the organ receiving mouth can be expanded and opened surely and quickly to take in the removed organ.
Different endo-bags addressing that question have been disclosed. The applicants of the present invention have also proposed an endo-bag in Japanese Patent Laid-open No. 9-173337 (unexamined).
FIG. 39 shows some examples of the prior art endo-bags.
An endo-bag 31 as shown in FIG. 39(a) has an elastic opening element 32 which springs open in the form of a ring when force is applied through an opening guide 34. The endo-bag 31, folded around the outer circumferencial surface of a guide inner cylinder 36, is housed inside an outer guide cylinder 35, with the opening element 32 stored in the opening guide 34. This endo-bag 31 is then inserted into the abdominal cavity by means of the outer guide cylinder 35, where the opening element 32 is caused to expand in the form of a ring by an opening means (not shown) so as to expand the bag 31 and to open the organ receiving mouth 33.
That method offered some advantages in that the endo-bag could be opened in a relatively simple mechanism. But since the opening element 32 having a certain rigidity and the opening guide 34 had to be used within the abdominal cavity almost with invisibility, it was necessary to take care so as not to harm the human internal organs and it was difficult to open the bag in an ideal state.
FIGS. 39(b) and (c) show endo-bags which are opened not by using a rigid element but by providing a hollow space in the whole or part of the bag into which air or the like is pumped to open the bag.
In the endo-bag 41 shown in FIG. 39(b), an organ receiving mouth 43 is provided with an inflation-type frame edge 42 formed of a ring-formed hollow space. In this inflation-type frame edge 42, a tube 45 is led out through a surgical instrument inserting portion 44. Into this tube 45, air or the like is pumped to inflate the inflation-type frame edge 42 which then opens the organ receiving mouth 43.
In the endo-bag 51 in FIG. 39(c), the whole bag is an inflation-type flabby cylinder 52 in shape. In this, air or the like is led from the surgical instrument inserting portion 54 through the tube 55 to inflate the inflation-type flabby cylinder 52 and then to open an organ receiving mouth 53. The reference numerals 46 and 56 indicate additionally provided surgical instrument inserting portions through which the forceps and the laparoscope are passed so as to permit treatment within the bag.
Those endo-bags were excellent with regard to safety, because the bag itself was formed of such materials as polyethylene sheet that were not harmful to the human body.
But the problem with those endo-bags were that a considerable amount of air was required for the bag to take shape and open. The pressure of air, too, had to be raised to a considerable level. Otherwise, the bag would not open in an ideal state and could deform under the slightest stress. If the inflation-type frame edge or the inflation-type flabby cylinder should burst out, the leaked air could push up the pressure in the abdominal cavity and contaminate the abdominal cavity. For that reason, there had been a call for development of an endo-bag that could open in an ideal state with a less amount of air.
Also, a variety of opening systems including those aforesaid examples had been disclosed, but there had been found no systems which were completed on the basis of consideration of opened form and three-dimensional tailoring. That is because such materials as polyethylene sheet or urethane sheet were selected for the endo-bag on account of foldability, strength, harmlessness to humans, transparency and others. And the pliability of those materials led to a belief that it was natural that the opened form should be round or the like.